pumpkinspice

How would this be a sign of diverting narcotics? Please elaborate, I don't understand.

I was thinking that would only be battery if the patient is oriented. This pt is confused so not necessarily able to make best choice for himself. To be clear, I provide a lot of encouragement until he allows me to apply the NP. But resident will just remove them shortly afterwards. Some nurses say just keep offering and monitor. Other say "well you can't force him so leave it" It feels like a no win situation. I encourage and it's battery or respect his wishes and it's neglect (because he's confused and demented) I don't know what to do😳

A resident in LTC in Ontario is confused and has COPD. They are often noncompliant with their supplemental oxygen and constantly removing nasal cannula. Consequently there O2 sat frequently drop to mid 70s with no resp. Distress noted. Do they have a right to refuse o2? Will I be guilty of neglect should they become hypoxic even though I frequently reapply their cannula? This resident is a DNR. I'm unable to find any articles online regarding this info, seems like a grey area. From other posts I have read, they can't decline if they're confused but also neglect if I don't reapply o2 constantly. Stuck between a rock and a hard place😟

Thank you for your replies! Yes both same dose of 1mg. I know it wouldn't be detrimental to give that low dose 2 hrs apart but just was wondering the proper way to administer

Hello, I've been unable to find a clear answer for this scenario despite my research efforts. I'd really appreciate any input! Thanks in advance! A resident has prn dilaudid q4h and scheduled dilaudid at 0600hrs. If she requests the prn at 0400hrs, could I still give the scheduled narc at 6 even though it's only 2 hrs from last dose? Does the prn q4h only mean having to wait 4 hrs between PRNS or does it include scheduled meds too? Thank you!

I think you're right. Thanks:)

I've been trying to cope with a residents difficult behaviors and am scared I will jeopardize my license because of her actions. She is pill seeking and requests prns frequently despite reminders she needs to wait. She often rings call bell for very minor things and I feel as though she is just attention seeking. Although that is stressful considering I have 60 other residents to care for, I am worried that she removes her nasal prongs then c/o SOB! After stabilizing her she will cry and beg me to stay with her but I just can't. I spend so much time answering her call bells but I need to tend to the other residents. The fact that she intentionally causes her SOB whenever she feels like she needs attention is stressing me out. I can't be with her 24/7..but I also can't let her o2 drop and not be there. She's her own poa and refuses to transfer to hospital when satting low although she says she feels like she'll die when it drops. Any advice pls!

Thanks for input

Yes, that's what I'll do. Thank you:)

I'm in canada

Psw. Not private duty

Kept awake through activities. But the client has very limited interests and attention span due to cognitive impairment. It's very difficult to keep her awake by continously introducing new activities and redirecting her repeated requests to nap

No, this isn't homework. I'm not a student. I personally feel it's wrong to refuse to allow someone to nap, especially someone in the state of health. I was hoping to hear reasoning from someone who feels otherwise because I just don't understand how this could be enforced. Does a POA have authority to request that even!?

Hypothetical situation: A 90+ year old woman with advanced dementia and cancer wants to nap during day. However, POA insists she does not sleep and be engaged entire day. Would you consider not allowing her to nap unethical?

Hi, Thank you so much for your input:) I didn't consider giving her more control..These are all great points that I will apply in my clinical practice and will be very compassionate and empathetic. Understanding and support can go a long way...

Many people in my school are working. It's definitely more difficult as it leaves less time for studying, but they seem to make it. Everyone has different situations, so when someone says "It can't be done", possibly they don't feel they could do that. But it's not impossible. I would look for all support available to you. I am in Ontario, and we have a lot of options here concerning support.

Very good advice, will be helpful when I start clinical next week. Thank you:)

Hi Everyone, Thank you for your explanations, I completely understand now. I definitively have good intentions and look forward to being a part of this site:) I'd like to explain my reasoning in the posted scenario. Quick recap: A patient underwent a radical mastectomy 2 days ago. She was given health teaching regarding exercises needed to prevent lymphedema. When the RPN enters the patient's room, she yells at the RPN stating "I don't want to do those exercises…can't you see this is really hard for me”. What is the best therapeutic response the nurse could use? What are the priority assessments in order from most to least importance? I think the best therapeutic response is to ask how the patient feels about her surgery. This is an open-ended question that allows her to give a lot of information and explain her anger and reluctance to do her exercises. Its an opportunity to health teach the importance of the exercise and build a trusting relationship. In turn, it will also reduce her stress which will not only improve her cooperation in performing exercises, but reduced stress can help her healing process. Regarding the priorities, I need to follow ABCD- airway and breathing a fine. I'm sure circulation is fine also. So I need to focus on the disability. I think I need to address the pain first. She can't do excerises if she's in pain and relieving it will improve her cooperation. Second, I think the exercises are important to avoid/reduce lymphedema and further complications. Lastly, communication is essential for said reasons. Hope I'm on the right track:)

why would you comment on this being my first post.?? I just signed up !! I think we all started off with one post at some point, don't you? Should I be ashamed Im asking for advice? Isn't giving and receiving advice, asking question etc what this site is about?? Geez..maybe you need some therapeutic communication yourself.

Wow, I'm really surprised by the snappy comments. I'm not looking for someone to do my homework. I have my own ideas and just wanted some input since I've never dealt with anything like this. VANurse2010 why would you comment on this being my first post.?? I just signed up !! I think we all started off with one post at some point, don't you? Should I be ashamed Im asking for advice? Isn't giving and receiving advice, asking question etc what this site is about?? Geez..maybe you need some therapeutic communication yourself. I was actually excited to find this site so I could learn new things and read about people's experiences. Unfortuantly you guys ruined that. Thanks.

Hi, I would really appreciate some advice for this situation. It is a school assignment question. A patient underwent a radical mastectomy 2 days ago. She was given health teaching regarding exercises needed to prevent lymphedema. When the RPN enters the patient's room, she yells at the RPN stating " [COLOR=#000000]I don't want to do those exercises…can't you see this is really hard for me”. What is the best therapeutic response the nurse could use? What are the priority assessments in order from most to least importance? Thanks in advance for any help/input![/COLOR]